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31.
There has been a long history of hospital trust cost–efficiency targets being used in the National Health Service (NHS), but there is little evidence about whether they are effective in reducing hospital unit costs and reducing the dispersion of unit costs between trusts. In 1997, the new Labour government announced that it would replace the purchaser efficiency index with a new approach to securing cost–efficiency gains from trusts. Since 1999/2000 trust efficiency targets have been based on reference costs. This article presents evidence to suggest that efficiency targets have not been effective and that the new reference cost based system of targets is irrelevant. The efficiency gains that trusts seek to achieve are those that emerge from the purchaser funding formula and the contracting process. 相似文献
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Allan W. Gray Michael D. Boehlje Brent A. Gloy Stephen P. Slinsky 《Review of Agricultural Economics》2004,26(2):238-253
A simulation model incorporating price and yield variability is used to examine the impact of government farm program and crop revenue coverage (CRC) insurance payments on the probability distribution of returns to land. Results indicate that Marketing Loan Program payments have the greatest impact on both the mean and standard deviation of returns. Agricultural Market Transition Act payments shift the distribution of returns without changing the variability, creating a reduction in relative risk. Market loss assistance payments increase the mean, reduce variability, and increase skewness. When combined, farm programs substantially increase the value that risk-averse producers place on the residual returns to land and substantially reduce the certainty equivalent value of CRC. 相似文献
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Poland's 1993 Enterprise and Bank Restructuring Programme (EBRP) tried to force state-owned commercial banks to build institutional capacity and resolve their problem loans. The outcome of its innovative bank-led workout (‘conciliation’) process, documented in this study of 62 firms, is decidedly mixed. The EBRP forced banks to confront their problems, helped them to build instituional capacity in their workout units, and furthered the difficult task of weeding out and closing clearly unviable firms. Yet it had limited power to promote needed restructuring or privatization in firms. The conciliation agreements were relatively unsophisticated and include few tangible requirements for operational or management change. The first two years of implementation saw a slowdown (over earlier years) in the rate of layoffs, a decline in average operating profitablility, and very little real privatization. The main impact of conciliation appears to have been to reduce debt service and thereby give firms ‘breathing room’. 相似文献
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The influence of social and cultural context, including imperial influences, and politics on the promulgation of the Companies Act 1956 in post independence India, focusing in particular on accounting regulations incorporated in the Act, is explored using a framework based on the work of McKinnon [McKinnon JL. The historical development of the operational form of corporate reporting regulation in Japan. New York: Garland; 1986]. Within the framework, the promulgation of the Companies Act 1956 is analysed into three phases: source, diffusion and reaction with all phases being influenced by the social and cultural context of India and political processes. In particular, the importance of the role of the government and the socio-economic and cultural context of India is indicated in both the need for, and in the process of, change to the Companies Act 1956. 相似文献
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While the public sector has historically played a very significant role in the direct provision of agricultural research, the appropriate role of government in the future is no longer apparent in a world with intellectual property rights (IPRs) and a concentrated privatized biotech research industry. This study develops a search/imperfect competition framework to examine the public role. The analysis shows that private firms have inadequate incentives to invest in research for varietal improvement relative to the social optimum even with completely enforceable IPRs. A government subsidy on research output can efficiently increase the amount of applied research to the socially optimal point. Government subsidy of the research cost can have the same effect on research and development expenditure. Expanding direct applied public research increases social welfare but cannot achieve a social optimum, as it reduces the already limited incentives for private firms to invest. Finally, in situations where basic research is underprovided, government should address these market failures as part of an optimal research policy. Overall, the analysis suggests that there is a role for public support of applied research, but this role is no longer direct public involvement in applied research where IPRs are well established. 相似文献
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